Patch and patch assembly for iontophoretic transdermal delivery of active agents for therapeutic and medicinal purposes

ABSTRACT

Embodiments of the invention provide patch assemblies for iontophoretic transdermal delivery of therapeutic agents. An embodiment provides a patch assembly comprising a conformable patch for delivery of the agent and having a tissue contacting side including an adhesive. The housing has a bottom surface for engaging a non-tissue contacting side of the patch, a current source such as a battery and a controller for controlling the delivery of the agent. The housing has sufficient flexibility such that when it is engaged with the patch to form the patch assembly and the patch is adhered to a target site on the patient&#39;s skin, the assembly has sufficient flexibility to deform with movement of the patient&#39;s skin to remain sufficiently adhered to the skin over an extended period of time to transdermally deliver a desired dose of the agent. Embodiments of the assembly may used to deliver a variety of therapeutic agents.

RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.12/898,671 filed Oct. 5, 2010 entitled “Patch And System ForIontophoretic Transdermal Delivery Of Active Agents For Therapeutic AndMedicinal Purposes”, issued as U.S. Pat. No. 8,903,485, which is anon-provisional filing that claims the benefit of U.S. ProvisionalPatent Application Ser. No. 61/249,247 filed Oct. 6, 2009, entitled“Patch And System For Iontophoretic Transdermal Delivery Of ActiveAgents For Therapeutic And Medicinal Purposes.” Said U.S. Ser. No.12/898,671 is also a continuation in part of U.S. patent applicationSer. No. 12/537,243 filed Aug. 6, 2009, entitled “Iontophoretic SystemFor Transdermal Delivery Of Active Agents For Therapeutic And MedicinalPurposes,” issued as U.S. Pat. No. 8,190,252. The aforementionedapplications are hereby incorporated by reference herein in theirentirety for all purposes.

FIELD OF THE INVENTION

Embodiments described herein relate to patches and systems foriontophoretic transdermal delivery of various therapeutic agents. Morespecifically, embodiments described herein relate to patches and systemsfor iontophoretic transdermal delivery of various iron containingcompounds.

BACKGROUND

Iontophoresis is a non-invasive method of propelling high concentrationsof a charged substance, known as the active agent, transdermally byrepulsive electromotive force using a small electrical charge. Thismethod has been used for the transdermal delivery of various compoundsincluding therapeutic agents. Traditionally, direct current has beenused to provide the driving current for iontophoresis. However there area number of shortcomings associated with the use of direct currentincluding limitations on the total amount of current that can bedelivered over time without causing injury to the skin, as well as thebuild up of capacitive charge in the skin layer which can oppose theelectromotive driving forces thus reducing the rate and total amount ofcompound delivered over time. Also, direct current can cause a localanesthetic effect to the skin resulting in burns and other thermaldamage to the skin because the user doesn't feel the injury to the skinoccurring at the time. Thus there is need for improved methods fordelivering various therapeutic agents using transdermal iontophoresis.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates an iontophoretic system for transdermal delivery ofan active agent, according to one or more embodiments.

FIG. 2 illustrates an alternative embodiment in which each of a pair ofelectrode assemblies are equipped to disperse an active agent into theskin layer, under another embodiment.

FIG. 3 is a top view of the electrode assemblies deployed on a skinlayer of the user.

FIG. 4 illustrates an alternating power source for use with embodimentssuch as described with FIG. 1 though FIG. 3.

FIG. 5A through FIG. 5F illustrate various waveforms or current outputvariations that can be used to promote a characteristic of the electrodeassemblies operation on a user's skin.

FIGS. 6a and 6b are perspective views showing an embodiment of asystem/patch assembly for iontophoretic transdermal delivery of anactive agent including a patch and an electronics assembly, FIG. 6ashows a top view, FIG. 6b shows a bottom view. FIG. 6c is a blockdiagram of an embodiment of the electronics assembly including acontroller, current source and current switching device.

FIG. 7a is a perspective view showing placement of the embodiment ofFIG. 6a and FIG. 6b on an example site on the skin of a user.

FIG. 7b is a lateral view showing an embodiment of a patch assemblyhaving a curved contour positioned at a tissue site having a curvedcontour.

DETAILED DESCRIPTION OF THE INVENTION

Embodiments described herein provide for an iontophoretic system fortransdermal delivery of drugs and other therapeutic agents. As usedherein, the term transdermal refers to the delivery of a compound, suchas a drug or other biological agent, through one or more layers of theskin (e.g., epidermis, dermis, etc). Iontophoresis is a non-invasivemethod of propelling high concentrations of a charged substance, knownas the active agent, transdermally using electrical current applied atthe skin layer. The active agent can include a drug or other therapeuticagent or biological compound.

More specifically, embodiments described herein include a system fortransdermal delivery of active agents for therapeutic and medicinalpurposes. The system includes a power source and at least two electrodeassembles. The power source provides an output current that alternatesbetween a maximum current value and a minimum current value; a pair ofelectrode assemblies. Each electrode assembly is configured to be heldin contact with a skin layer of a user. Additionally, each electrodeassembly includes an electrode that is coupled to the power source toreceive the output current from the power source. At least one of theelectrode assemblies in the pair includes a medium that carries anactive agent having a charge, the medium being provided on the at leastone electrode assembly to enable the output current to repel the activeagent into the skin layer for a duration in which the output current hasa polarity that is the same as a polarity of the active agent.

According to one or more embodiments, an output current such asdescribed is a charged balanced alternating current (AC) output. Thecharged balance AC output means over a given duration, the amount ofcurrent delivered at each polarity is substantially equivalent. As usedherein substantially equivalent means that two values are within 80% ofone another, and more preferably within 90% or 99% waveform.

In another aspect, embodiments of the invention provide an iontophoretictransdermal delivery system which include a skin conformable patch andan electronics assembly. The patch includes first and second electrodeassemblies which include electrodes. One or both of electrode assembliescan include a pair of tissue contacting ring shape electrodesconcentrically spaced or otherwise arranged to reduce edge effects.

The electronics assembly includes a housing which may be configured tobe detachably coupled to the conformable patch via one or moredetachment elements. The housing can include a curved shaped contourconfigured to correspond to the contour of the skin surface on theportion of the body where the housing and patch are placed (e.g., thecontour of the arm, leg or abdomen). The housing itself can beconformable so as to at least partially conform to the contour of theskin surface where the housing and patch are placed.

The housing will also typically include a current source such as anelectrochemical battery and a microprocessor or other controller. Thebattery can include various electro-chemistries known in the art and canbe rechargeable. Also, it may have a selectable capacity to delivercurrent to skin for transdermal delivery of the therapeutic agent forperiods ranging from 2 to 24 hours or even longer. Other current sourcesare also contemplated such as various storage capacitors. The batterymay be positioned in a cavity within the housing.

The controller can include a microprocessor or other electroniccontroller for controlling one or more aspects of the iontophoreticdelivery of the agent to the skin. The controller can also include anintegrated or separate power controller for controlling the delivery ofcurrent to the skin. One or both of the controllers can be coupled to anH-bridge for limiting the delivery of current to the skin.

Single Point Disbursement

FIG. 1 illustrates an iontophoretic system for transdermal delivery ofan active agent, according to one or more embodiments. A system 100 isshown in a deployed (i.e. operational) state, and comprises a pair ofactive electrode assemblies 110, 112 and alternating power source 108that combine to enable the transdermal delivery of a medicinal ortherapeutic (“active”) agent 102 into a user's tissue. Therapeutic agent102 can comprise one or more drugs or other therapeutic agents. In thedeployed state, the pair of electrode assemblies 110, 112 are positionedon the exterior skin layer of the user. In one embodiment, thealternating power source 108 forces the agent 102 to be dispensed fromone of the electrode assemblies in the pair (shown as electrode assembly110 in FIG. 1). More specifically, the active agent 102 is selected tohave an ionic charge, and the alternating power source 108 is connectedto electrode assembly 110 to repel the active agent 102 into the skinlayer of the user at instances when the alternating power source has thesame polarity as the active agent. As such, the driving mechanism thatcauses the active agent 102 to dispense into the skin layer isintermittent and alternating (to match the output of the power source108).

With specific reference to FIG. 1, the power source 108, electrodeassemblies 110, 112 and the user's (also referred to herein as patient)skin layer or tissue form a circuit to enable delivery of the activeagent from at least one of the electrode assemblies. More specifically,FIG. 1 illustrates a single disbursement configuration in which thefirst electrode assembly 110 contains the active agent, and the secondelectrode assembly 112 serves as a return without the active agent. Inthe configuration shown, the second electrode assembly 112 serves as thereturn for completing the circuit with power source 108 and the firstelectrode assembly 110. For a duration, the output current is provided apolarity that matches that of the charge of the active agent. Thepresence of the output current, flowing via the circuit formed by theother electrode assembly and the power source 108, results in thecharged active agent being repulsed from the electrode assembly 110 intothe skin layer of the user. Thus, in a configuration shown by FIG. 1,the first active electrode assembly 110 is equipped with the activeagent 102, and the power source 108 directs the active agent from thefirst electrode assembly 110 into the skin layer when the polarity ofthe output current matches that of the charge of the active agent.

As described below, the power source 108 may vary the output of thecurrent output to alternate durations in which the active agent isdelivered. In one embodiment, the power source 108 varies the outputcurrent between a maximum current value (coinciding with a deliveryduration) and a minimum current value (coinciding with non-deliveryduration). The minimum current value corresponds to either no currentoutput, or a reverse current output. As described elsewhere, the reversecurrent output may serve as a retention mechanism that activelyprecludes the active agent from diffusing into the skin layer (e.g., dueto electrostatic attractive forces). Thus, a delivery duration coincideswith a duration in which an output current from the power source 108 haspolarity to match that of the active agent. A non-delivery durationcoincides with either an output current from the power source that isopposite in polarity to that of the active agent, or to a duration thatcoincides with substantially no current output.

In a system such as described with FIG. 1, some embodiments provide forthe delivery/non-delivery durations to be symmetrical or equal. Forexample, delivery/non-delivery durations may each last x milliseconds,seconds, or minutes, to match, for example, symmetrical waveforms of theoutput (e.g. sinusoidal, square wave etc.). In other embodiments, thedelivery/non-delivery durations are asymmetrical or unequal. Forexample, the delivery duration may last several minutes, and thenon-delivery duration may last only seconds or otherwise be less thanthe delivery duration. The delivery/non-delivery durations may repeat,or pass through only a single cycle (i.e., one delivery duration and onenon-delivery duration).

Each electrode assembly 110, 112 includes an electrode 130 and a contactthickness 118. The contact thickness 118 of each electrode assembly 110,120 may be in form of a patch fabricated from layers of elastomeric orother flexible polymer material. The contact thickness 118 may include,for example, adhesives for enabling the respective electrode assemblies110, 112 to be deployed on the skin layer of the user and to remainadhered over an extended period of time during movement of the skin.Likewise, the electrode 130 corresponds to one or more elements orlayers that extend the conductive path from the alternating power sourceto the contact thickness and/or skin layer. In one embodiment, aconnector 132 connects the electrode 130 to leads 133 of powers source108. The electrode 130 corresponds to a metal layer or element(s) (e.g.wiring, contact elements etc.) that extends or connects to the connector132. The electrode 130 may comprise a separate layer from the contactthickness 118, which includes a medium 122 for carrying the active agent102. However, in some variations, the electrode 130 includes elements,such as particles or contact elements that are integrated or providedwith the contact thickness 118. In one implementation, the electrode 130is comprised of conductive material, such as metal (e.g. silver) orconductive carbon material (graphite sheets). In an embodiment depictedby FIG. 1, electrode 130 is a conductive layer that overlay the contactthickness 118. As described below, the contact thickness 118 includesthicknesses for dispersing the active agent 102, as well as material toenable the electrode assembly to be adhered to skin, for example, a skinadhesive known in the art such as those used on self adhering bandages.In many embodiments, the active agent is dissolved in an aqueous orother carrier solution, for example, isopropyl alcohol, DMSO and likecompounds.

As previously mentioned, in an embodiment of FIG. 1, only one of theelectrode assemblies in the pair (shown as electrode assembly 110) isused to deliver the active agent 102 into the user's skin. The medium122 of the first electrode assembly 110 provides a reservoir or retainerthat contains the active agent, for example, in embodiments where theactive agent is dissolved in a carrier solution. More specifically, themedium 122 of the contact thickness 118 includes a tissue contactingporous layer 124, which can either be separate or part of a reservoir.The porous layer 124 can be configured to absorb the carrier solutionfrom the reservoir and in turn, wick the solution into contact with theskin (e.g. by capillary action). The porosity of the porous layer 124may be selected based on various parameters. For example, the porositymay be selected based on the concentration or transport characteristicsof the active agent. More specifically, for example, high porosities canbe selected for higher molecular weight therapeutic agents and/ortherapeutic agents solutions having greater viscosity. Suitable porousmaterials for porous layer 124 can comprise compressed cotton or otherfibrous mesh such as meshes made from various polymer fibers.

The electrode assemblies 110, 112 can be constructed as disposable orreusable. If disposable, the electrode assembly 110 (carrying the activeagent) is manufactured or retailed to include the active agent in themedium 122. For reusable embodiments of assemblies 110 and 112, anembodiment provides that the electrode assembly 110 includes an intakeconduit and optional self-sealing port that enables the active agent 102to be dispersed in the medium 122 for delivery. In one embodiment, theself-sealing port is formed from silicone or other elastomeric material,so as to enable the electrode assembly 110 to be filled with the activeagent.

The alternating power source 108 may correspond to a battery, such as arechargeable Lithium-Ion battery pack. As an alternative, thealternating power source 108 may, include or provide an interface, toanother power source, such as a solar cell. Circuitry (such as describedwith FIG. 4) may be used to convert the direct-current (DC) power outputto an alternating signal of a specified waveform. As mentionedelsewhere, the specified waveform may be short (e.g. milliseconds), long(minutes), symmetrical (delivery/non-delivery are equal), orasymmetrical (delivery/non-delivery are now equal).

In various embodiments, the electrode assemblies 110, 112 and thealternating power source 108 may be provided in connection with one ormore housing segments. For example, the power source 108, electrodeassemblies 110, 112, and wiring or connectors that interconnect thepower source and the electrode assemblies may all be contained by ahousing, or combination of integrated housing segments. In this way, thesystem of electrode assemblies 110, 112 may be provided as a product,device or kit that can be assembled and deployed by the user. The kitmay further include instructions for use.

When deployed and made operational, the active agent is selected to havean ionic charge that can be sufficiently repulsed by the presence ofcurrent having the same polarity. The active agent is distributed in themedium 122 of the electrode assembly 110. The power source 108 isconnected and signaled, resulting in a circuit being formed between thealternating power source 108, electrode assembly 110 containing theactive agent, and the electrode assembly 112 providing the returnelectrode. In the durations when the current has the same polarity asthe charge of the active agent, the active agent is repulsed from themedium 122 of the electrode assembly 110 into the skin layer of theuser. In the durations when the current has the opposite polarity as thecharge of the active agent, the active agent is not repulsed. Thus, theactive agent is induced to travel into the skin layer in alternatingdurations to match the alternating power of the alternating power source108. The frequency of the alternating power source 108 may vary greatly.In particular, the frequency of the alternating power source may be inthe range of milliseconds (e.g. 1/60 seconds) or minutes (e.g. tenminutes).

Among other benefits, the diffusion of the active agent into the skinlayer can be completely stopped with the switch in the current polarity.Thus, use of the alternating power source 108 enables the active agentto be stopped from entering the skin layer at alternating instances.This enables, for example, better control of the amount of active agentdelivered into the skin layer in a given duration.

Double Point Disbursement

FIG. 2 illustrates an alternative embodiment in which each of a pair ofelectrode assemblies are equipped to disperse an active agent into theskin layer, under another embodiment. More specifically, an embodimentof FIG. 2 shows a first and second electrode assembly 210, 212, each ofwhich can include a construction similar to that shown with the firstelectrode assembly 110 of FIG. 1. Accordingly, the first and secondelectrode assemblies 210, 212 each include an electrode 230 positionedover or in operative relationship to a contact thickness 218. Thecontact thickness 218 of each electrode assembly 210, 220 may be in formof a patch fabricated from layers of elastomeric or other flexiblepolymer material. The contact thickness 218 may include, for example,adhesives for enabling the respective electrode assemblies 210, 212 tobe deployed on the skin layer of the user. Likewise, the electrode 230of each electrode assembly 210, 212 may correspond to one or more metallayer or element(s) (e.g. wiring, contact elements etc.) that extends orconnects to a connector 232, which in turn connects that electrode 230to leads 233 of powers source 208. On each electrode assembly 210, 212,the electrode 230 may comprise a separate layer from the contactthickness 218, which includes a medium 222 for carrying the active agent202. However, in some variations, the electrode 230 includes elements,such as particles or contact elements, that are integrated or providedwith the contact thickness 218. In one implementation, the electrode 230is comprised of conductive material, such as metal (e.g. silver) orconductive carbon material (graphite sheets).

The medium 222 of the electrode assemblies 210, 212 includes a tissuecontacting porous layer 224, which can either be separate or part of areservoir. Similarly, in an implementation in which one or both of theelectrode assemblies 210, 212 are reusable, a self sealing port (notshown) may be included to enable the active agent to be dispersed in themedium 222 for delivery to the skin layer.

As a variation, the electrode assemblies 210, 212 may both be capable ofretaining the active agent to dispense, but the electrode assemblies210, 212 may have differing constructions. For example, the contactlayer and amount of active agent 202 each electrode assembly 210, 212can retain may be different.

In contrast to an embodiment of FIG. 1, the alternating source 208 iselectrically connected to cause dispersion of active agent 202 from bothelectrode assemblies 210, 212 in alternating fashion. In one embodiment,the alternating power source 208 alternates the power signal to eachelectrode so that the delivery durations form each electrode assemblyare the same. Such a configuration enables delivery durations toalternate between electrode assemblies. Among other benefits,alternating the delivery durations between electrode assemblies enablescontinuous transdermal delivery of Z agents using alternating points inthe user's skin, to avoid, for example, skin irritation or saturation.

Similar to prior embodiments of FIG. 1, an embodiment such as thatdescribed with FIG. 2 may be constructed as a device or kit that can beassembled and deployed for use by the user. Accordingly, one or morehousing segments may be incorporated to integrate the electrodeassemblies 210, 212 and/or power source 208.

FIG. 3 is a top view of the electrode assemblies deployed on a skinlayer of the user. The electrode assemblies 310, 312 may be implementedto disperse an active agent from one electrode assembly (single pointdisbursement, such as described with FIG. 1) or from both electrodeassemblies 310, 312 (double point disbursement, such as described withFIG. 2). In a single point disbursement configuration, the alternatingpower source 308 repulses the active agent into the skin 322 (into thepaper, as depicted by Z axis) in alternating durations when the suppliedcurrent has the same polarity as the charge of the active agent. Asmentioned elsewhere, the alternating durations may last milliseconds,seconds, or minutes. The alternating durations may also be asymmetricalor unequal in duration. In a single point disbursement, for example,current is extended from the alternating power source 308 through thecontact thickness (see element 118 of FIG. 1) of the first electrodeassembly 310, into the skin layer 322, and to the second electrode 312(serving as the return) to form a circuit with the alternating powersource 308. The active agent is thus dispensed from one electrodeassembly 310 into the skin layer in alternating durations (durationsmarked by t₁, t₃, t_(n)) set by the frequency of the current from thepower source 108. Significantly, the active agent does not dispensepassively in the alternating instances when the polarity of the currentis opposite to the charge (i.e. attractive polarity) of the active agent(durations marked by t₂, t₄, t_(n+1)). In that instance, the oppositepolarity of the current/voltage serves as a retention mechanism of theactive agent within the electrode assembly 310.

In a double point disbursement configuration (such as described with anembodiment of FIG. 2), the alternating power source 308 alternates whichelectrode assembly is directing the active agent into the skin layer322. In one implementation, for example, both electrode assemblies maycarry the active agent, and the active agent is positively charged. At afirst duration when the current has a positive polarity, (i) apositively charged active agent in the first electrode assembly 310 isdirected into the skin layer, (ii) a positively charged active agent inthe second electrode assembly 312 is retained, or precluded from beingdiffused into the skin layer. In the next duration, when the current hasthe negative polarity, (i) a negatively charged active agent in thefirst electrode assembly 310 is retained or precluded from beingdiffused into the skin layer; and (ii) a positively charged active agentin the second electrode assembly 312 is directed into the skin layer.The timing sequence of the first electrode assembly 310 thus may bedescribed as (i) dispense at durations marked by (t₁, t₃, t_(n)), and(ii) retain at durations marked by (t₂, t₄, t_(n+1)). Likewise, timingsequence of the second electrode assembly 312 may be described as (i)dispense at durations marked (t₂, t₄, t_(n+1)) and (ii) retain atdurations marked by (t₁, t₃, t_(n)).

With regard to either the single or double point disbursementconfiguration, the frequency of the electrode assemblies operation maybe measured in milliseconds, seconds or minutes. For example, in asingle disbursement embodiment, a drug-on mode of operation may lastseveral minutes, followed by a drug-off mode. The time periods for thedrug-on and drug-off states may be the same or different. For example,the drug-on states may last several minutes, but the drug-off state maybe much shorter.

According to an embodiment, the electrode assemblies 310, 312 can beused in connection with the following mechanisms to initiate and/or stopuse of the electrode assemblies: (i) input from a user input mechanism342, (ii) input from a sensor 344 or sensor system for detecting ahuman/physiological condition, and/or (iii) a timer 346. A user inputmechanism may correspond to a switch, button or similar mechanism thatthe user can trigger. The user input mechanism 342 may be used toinitiate use of the electrode assemblies 310, 312 once the user placesthe electrode assemblies on his skin. The user input mechanism 342 mayalso be used to stop the electrode assemblies at the user's election.For example, the user may deploy the electrode assemblies on his skinlayer, then press a button or cause the power source to power theelectrodes at a desired time.

The sensor 344 (or sensor system) may correspond to a physiologicalsensor that triggers the electrode assemblies to operate when the sensor344 detects a physiological condition. For example, the sensor 344 maycorrespond to a glucose monitor for diabetics; the glucose conditionstrigger sensor 344 to actuate the electrode assemblies.

As an alternative or variation, a system such as described with FIG. 3may be provided with an interface 345 to enable the power source 308 tobe triggered or operated by the output of sensor 344 or other sensor. Inthis way, a system such as described by various embodiments may bedeployed in an environment where the user has one or more pre-existingbody sensors to detect various conditions. The interface 345 may includelogic or circuitry to enable interpretation of the sensor output fromthe user's sensor system.

The timer 346 corresponds to a mechanism, implemented by, for example,logic or circuitry, that (i) switches the power source 308 from a stateof delivery (i.e. signal current output to the electrode assemblies) toa state of non-delivery through current/voltage output; and/or (ii)switches the power source 308 from a state of non-delivery (i.e. signalreverse current or no current) to a state of delivery. In a typicalimplementation, the timer 346 may switch the power source 308 into astate in which the current output matches the charge of the active agentfor a set duration, then switch the power source to either turn off oroutput a reverse current.

As an alternative or variation to embodiments described, the sensor 344or sensor system is configured to trigger electrode assemblies 310, 312to cease operation when a physiological condition is no longer present.As still another variation, rather than switch off, an embodiment mayswitch the mode of operation of the electrode assemblies from a drugdeliver to a drug-off state. The drug-off state differs from an offstate, in that a reverse current may be used to (i) maintain theelectrodes in the deployed state, but (ii) retains the active agent withthe electrode as a result of the polarity of the current. For example,with reference to an embodiment of FIG. 1, when the sensor 344 detectspresence of the physiological condition, the electrode assembly 310switches on to deliver a type of active agent to address the condition.After the physiological condition is being detected as being treated(either by sensor or timer), the electrode assembly 310 switches into areverse current state, so that no drug is delivered into the skin layer.Subsequent re-occurrence of the condition may trigger the firstelectrode assembly 310 into the drug delivery mode again upon the sensor344 detecting re-occurrence of the physiological condition.

Various embodiments described above provide for alternatingcurrent/voltage to drive a charged active agent from an electrodeassembly into the skin layer of the user. Embodiments further recognizethat a waveform of the alternating current/voltage that is output fromthe alternating power source may be of consequence as to the operationand application for the transdermal iontophoretic delivery systemdescribed by various embodiments. Numerous current output waveforms andapplications for using such waveforms are described with FIG. 5A throughFIG. 5F.

Applications and Waveforms

FIG. 4 illustrates an alternating power source for use with embodimentssuch as described with FIG. 1 though FIG. 3. The waveform generator 400has an input to receive a DC current from a battery (or other powersource, such as photovoltaic solar cell) and converts the input into ashaped waveform. Examples of the shaped waveform may be a sinusoidalwaveform, a square waveform, a trapezoidal waveform, or other similarwaveforms. Some waveforms, such as square waves, in particular, mayshort or long frequency. Short frequency waveforms may repeat severaltimes per second (e.g. 1/60 seconds), while long frequency waveforms mayrepeat once over several minutes (e.g. 20 minutes). In generating thewaveforms, some embodiments use a voltage that is in range of 1 to 100volts.

The waveform generator 400 includes power inverter 410 and waveformshaper 420. Power inverter 410 has an input to receive the DC currentand an output to transmit an AC current to the waveform shaper. Thewaveform shaper 420 includes circuitry to shape the AC current to thedesired waveform. For example, the waveform shaper 420 may includecapacitive or inductive elements in order to obtain the desired shape ofthe waveform. The shaped waveform is outputted by the waveform generator400.

FIG. 5A through FIG. 5F illustrates various waveforms or current outputvariations (over time) that can be used to promote a characteristic ofthe electrode assemblies operation on a user's skin. Embodiments such asdescribed may be implemented in either a single (see FIG. 1) or double(see FIG. 2) disbursement configuration. In describing an embodiment ofFIG. 5A-5F, reference may be made to elements or numerals of FIG. 3 forpurpose of illustration. Numerous embodiments described herein providefor waveforms that vary between a given polarity and zero, wherein atpolarity, the current causes the active agent to repel in the skinlayer. In other embodiments, the waveforms have alternative betweenpositive and negative polarity. In some embodiments, the alternatingcurrents can be delivered to each electrode assembly that is in use(whether or not the electrode assembly has the active agent). Byorienting the waveform to alternate in a charged-balance fashion,electrical toxicity or damage to the skin can be reduced or minimized.In other embodiments, an alternating current is used that is orientedtowards being balanced in charge, but some asymmetry may exist. However,the amount of asymmetry may be kept below that which causes electricaltoxicity to the skin.

The waveforms described below are variable between a minimum and maximumvalue. Some embodiments, such as described with FIG. 5B, may bealternating in charge value (i.e. include reverse polarity). In suchembodiments, the current delivery may be balanced in charge.

FIG. 5A illustrates a waveform 430 that includes an extended or longdrug delivery phase, according to an embodiment. In some embodiments,the skin layer may be assumed to handle only a maximum amount of currentin a given duration (max current delivery) (e.g. 80 milliamps perminute). For a given amperage, the duration of the output of thealternating power source may be set to not exceed the max currentdelivery. The delivery duration may be set to some portion or fraction(e.g. 50% for n=2) of the overall period of the current output I₁. Forexample, in some implementations, the max current delivery (I₁) isassumed to be 80 milliamps for one minute. In such an implementation,the delivery duration is set for 20 seconds on 4 milliamp output. Ratherthan switch to negative polarity, the output of the power source 308 mayalternate to no amperage output (rather than switch polarity). While thewaveform depicted in FIG. 5A is rectangular, the waveform may have analternative shape (e.g. sinusoidal, trapezoidal), with the currentdelivery corresponding to the area under the curve. In the example shownby FIG. 5A, the alternating power source 308 initiates a deliveryduration on one electrode, with delivery durations being set by acurrent that has a polarity that matches that of the charge of theactive agent. The current may alternate to zero output, in which thedrug delivery is substantially ceased. Thus, the no-delivery durationmay coincide with no current output, rather than reverse current.

FIG. 5B illustrates another embodiment in which the alternating powersignal outputs a symmetrical square wave. FIG. 5B (and other waveformsillustrated herein) illustrate use of charged balance alternatingcurrents. For example, symmetrical waveforms in polarity may beconsidered as charged balance. Depending on the application, the cyclemay be long (e.g. 20 minutes) or short ( 1/60 seconds). The deliveryduration may correspond to half of the period of the waveform. In theimplementation shown, a reverse current is used to in the non-deliveryduration, to actively prevent agent delivery to the skin layer.

FIG. 5C illustrates another embodiment in which the alternating powersignal outputs an asymmetrical square wave, in that the deliveryduration is different than the non-delivery duration. More specifically,the asymmetrical square wave may include longer delivery durations (t₁),followed by short(er) rest durations (t₂). The rest durations maycorrespond to periods of no current, or as shown, reverse current (I₂).In one application, the rest duration enable the skin layer torecuperate from the drug delivery in the prior duration (e.g., todissipate any heat, concentration of ions, or other by productsresulting from the delivery of current). As an alternative or variation,the rest period may follow a period where no current is applied to theskin layer, so as to enable the skin layer to recuperate fromapplication of current.

FIG. 5D illustrates another embodiment in which the alternating powersignal is trapezoidal, so as to include a ramp-up and/or ramp-down. Asdepicted, I₁ is the maximum current output generated from the powersource 308. The ramp-up period extends for a duration t_(r), selectedfor reasons that include enabling the user to physically accustom to theapplication of current and/or active agent. The period may be long, toenable the ramp-up duration to be effective. In an embodiment, aramp-down period may optionally be implemented.

FIG. 5E and FIG. 5F illustrate alternative waveform variations in whichhigh-frequency oscillations are superimposed on a base waveform. Thebase waveform may have a period that lasts seconds or minutes,corresponding to output current to the electrode assemblies ranging froma maximum (e.g. 4 MA) to no current and/or reverse current. Thehigh-frequency oscillations reflect small variations in the currentvalue at instances in the period. The period of the high-frequencyoscillations may be one or more magnitudes shorter than that of the basewaveform. As an example, the base waveform may have a period rangingseconds to minutes, and the high-frequency oscillations of the waveformmay have a period that ranges between milliseconds and seconds. Theeffect of the high-frequency oscillations is to reduce the effects ofthe capacitive charge in the skin layer in receiving the active agent.The high frequency oscillations may also be used to facilitate transportof the active agent through the skin including the stratum corneum bycausing oscillations in the movement of the active agent as it travelsthrough the skin so as to find pathways of least resistance throughskin. In such embodiments, the high frequency oscillations may beadjusted to enhance this effect through use of modeling (e.g.,pharmacokinetic modeling) and/or the patients age, skin type and skinlocation.

The base waveform may be selected for considerations such as describedin prior embodiments. For example, in FIG. 5E, the waveform includes aramp-up time period. In FIG. 5F, the waveform has a delivery durationthat is switched to a non-delivery duration. An embodiment of FIG. 5Fillustrates that the high-frequency oscillations may be generated to bepresent only during the delivery duration.

Referring now to FIGS. 6a, 6b and 6c and 7a and 7b , in variousembodiments, a system 500 (also described herein as patch assembly 500)for iontophoretic transdermal delivery of various drugs and othertherapeutic agents can comprise a skin conformable patch 505 and anelectronics assembly 550. Patch 505 includes first and second electrodeassemblies 510 and 512 which can correspond to one more embodiments ofelectrode assemblies described herein including embodimentscorresponding to elements 110 and 112 and/or elements 210 and 212. Thematerials used to fabricate the electrode portions of the assemblies caninclude various corrosion resistant materials such as graphite furtherdescribed in U.S. Provisional Patent Application Ser. No. 61/221,010which is fully incorporated by reference herein for all purposes. Also,one or both of electrode assemblies 510 and 512 can include a pair 520of tissue contacting ring shaped electrodes 521 and 522 concentricallyspaced or otherwise arranged to reduce edge effects as is furtherdescribed in U.S. Provisional Patent Application Ser. No. 61/224,453which is fully incorporated by reference herein for all purposes.

Electronics assembly 550 typically includes a housing 560 which engagespatch 505 so as to form patch assembly 500. Housing 560 includes abottom and top surface 561 and 562 respectively, with the bottom surface561 typically being the area of contact for engaging patch 505, thoughother arrangements are also contemplated. In particular embodiments, thehousing 560 can be configured to be detachably coupled to patch 505 viaone or more detachment elements 600.

Housing 560 can have a variety of shapes. In many embodiments, it caninclude a shaped contour 563 such as a curved shaped contour 564 (whichcan be for one or both of bottom surface 561 and top surface 562) thatis configured to correspond to the contour C of the skin surface SS atthe target tissue site TS where patch assembly 500 is placed such as thecontour of the patients arm, leg or abdomen (e.g., on the front or sideof the stomach including below the waist line so as to not be visible).Contours 563 and 564 may i) correspond to a standard contour for aparticular target site; ii) may come in different sizes and shapes fordifferent target tissue sites and sizes of patients; or iii) may becustom shaped for the particular patient and target tissue site. Also,the housing 560 can be conformable so as to at least partially conformto the contour C of the skin surface at the target tissue site TS wherethe patch 505 and housing 560 are placed (both when the patient is stilland when he or she is moving resulting in bending movement and otherdeformation of the skin such that the skin surface contour is a flexingcontour). Accordingly, in various embodiments, all or a portion of thehousing can comprise various flexible polymers known in the art such asvarious elastomeric polymers, e.g., silicone and polyurethane. Otherflexible polymers are also contemplated. The flexibility/conformabilityof the housing can also be configured to vary over the length of thehousing to meet the needs of the particular target tissue site TS. Forexample, the housing can be configured to have the greatest amount offlexibility at its center portions 560 c (which can be achieved in someembodiments by putting a crimp or articulated zone 560 a near the centerof the housing). Also, the flexibility profile of the housing 560 can bematched or otherwise correlated to the shape and flexibility profile ofthe patch 505. For example, in particular embodiments theflexibility/conformability of the housing can be configured forembodiments of the patch 505 having ring shaped electrodes 521 and 522.In these and related embodiments, housing 560 may have a structure whichinclude areas 566 of greater flexibility (e.g., less stiffness) whichmay approximately align with ring shaped electrodes 521 and 522 (orothers) such that the overall flexibility of the assembly 500 is notdecreased over these areas. Areas 566 can have a shape which correspondsto the shape of electrodes 521 and 522 (or other shaped electrodes),though the size of the areas can be different from the size of theelectrodes. Areas 566 can be achieved by decreasing the thickness of thehousing in these areas and/or the use of more flexible materials. Otherstructures for housing 560 including shaped areas 566 are alsocontemplated, such as structures which have oval shapes areas 566 oreven recessed areas 566.

Also in various embodiments, housing 560 can not only be conformable,but also have a profile 565 shaped and sized such that the entire patchassembly 500 can be worn beneath the user's clothing and can bend andflex sufficiently so that: i) it is not readily detached by pressure orforce from the user's clothing (due to movement of the clothes and/orskin), allowing the patch assembly 500 stay on for extended periods whenadhered to a tissue site underneath the user's clothes; and ii) is notreadily visible beneath the user's clothes. In various embodiments, theprofile 565 of the housing can have a contour 564 (of one or both of topand bottom surfaces 562 and 561) which corresponds to the contour C ofthe surface of the patient's arm, leg, abdomen or other target tissuesite. Further, embodiments of the housing 560 can be sized, shaped andotherwise fabricated to bend and flex sufficiently to account formovement of the patient's skin when the patch assembly is placed on thepatient's abdomen, arm, leg and other target tissue sites. In this way,even when placed under clothes (or not), the patch assembly can remainsufficiently adhered/attached to the patient's skin for an extendedperiod of time so as to allow a desired dose of the drug or othertherapeutic agent 102 to be delivered. In various embodiments, the timeperiod can be up to 24 hours, up to three days, up to a week with evenlonger periods contemplated. Specific combinations of a patch 505 andhousing 560 can be configured for specific desired attachment periodsusing one or more factors described herein (e.g., flexibility surfacearea, etc). For embodiments of the patch including elemental iron, suchconfigurations can allow the patch to remain sufficiently adhered to thepatient's skin for a sufficient time to deliver a therapeutic dose ofelemental iron for the treatment of iron deficient anemia (e.g., 1 to100 mg with specific embodiments of 20, 30 and 50 mg) at rates whichfacilitate uptake and utilization by the patient's iron metabolism.Similar configurations and methods can be employed for delivery of otherdrugs and therapeutic agents listed in Table 1.

Further, one or more of the size and shape (e.g., shape of the housingbottom surface 561 such as oval, circular, dogbone etc) and flexibilityof the housing 560 can be selected relative to one or more of the sizeand shape (e.g., shape of patch surface 505s) and flexibility of patch505 such that when the patch assembly 500 is worn openly or beneath thepatient's clothes, the applied amount of force from the housing to theskin surface beneath the patch (due to movement of the patient's skin)or the clothing to the skin surface beneath the patch 505 (due tomovement of the clothing or skin) is fairly uniform (e.g., there is ansubstantially uniform force distribution with minimal areas of forceconcentration). In use, these and related embodiments serve to minimizethe amount of thermal, electrical or other injury to the skin from highcurrent densities and/or hot spots from such force concentrations.Additionally for embodiments using dual point disbursement oftherapeutic agent(s) 102 from embodiments of patch 505 having two moreor electrode assemblies (e.g., electrode assemblies 110, and 112) suchconfigurations minimizing force concentrations (from skin movement etc)also serve to minimize any effect on the delivery of therapeutic agentfrom the first electrode relative to the second electrode (or others).In particular embodiments, this can serve to minimize any effect on thedelivery rate or total delivered amount of therapeutic agent from thefirst electrode relative to the second (or other electrodes).

In particular embodiments, such results can be achieved by matching theflexibility of the housing 560 to the patch 505 (either approximatelyequivalent or a selected amount higher or lower, e.g., 5 to 50%) as wellas configuring the surface area of patch to be large enough relative tothe surface area of the housing so as produce a snow-shoe like effect soas to evenly distribute any applied force to the housing from clothingor (other applied force such as that due to movement of the skin) overthe entire surface area of the patch. Surface area ratios in the rangeof 1:1.5 to 1:10 (housing surface area to patch surface area) arecontemplated, with specific embodiments of 1:2, 1:3, 1:5.

In still other embodiments, the housing 560 or patch 505 may include apressures sensor 567, such as a solid state strain gauge which sensesthe amount of force applied by the user's clothes to the housing and orpatch. Input from the pressure sensor can then be used to modulate(either increase or decrease) current delivered to the patch relative tothe applied force. The current can be modulated down to prevent thedevelopment of hot spots on the patch from excessive pressure ormodulated up to account for any increase in the electrical impedance ofthe skin due to the applied pressure.

Assembly 550 will typically include a power source 570 (also referred toherein as current source 570) and a controller 530 (e.g., amicroprocessor) for controlling one or more aspects of the iontophoreticdelivery of the agent to the skin. Controller 530 can also include anintegrated or separate power controller 535 for controlling the deliveryof current to the skin. One or both of the controllers 530 and 535 canbe coupled to an H-bridge or other current switching/limiting device 540for limiting or otherwise controlling the delivery of current to theskin. The housing will also typically include a cavity 580 for currentsource 570, such as a cylindrical shaped cavity which may be sized forstandard size batteries such as AA or AAA batteries. Other shapes forcavity 580 are also contemplated.

In various embodiments, current source 570 can comprise one or moreelectrochemical batteries including an alkaline, lithium, lithium ionand like chemistries. For ease of discussion, current source 570 will bereferred to herein as battery 570 but other current sources are equallyapplicable. Battery 570 can also comprise a rechargeable battery knownin the art. The battery 570 can have a selected capacity to deliversufficient current/voltage to the skin for transdermal delivery of thetherapeutic agent for periods ranging from 2 to 24 hours or even longer.Power source 570 may also correspond to alternating power source 108described herein. Accordingly, in embodiments including anelectrochemical battery(s), power source 570 may include circuitry forconverting a DC signal from the battery(s) into an AC signal. Otherpower/current sources 570 are also contemplated, such as various storagecapacitors and piezo-electric based energy harvesting devices.

The patch 505 will typically include one or more conductive areas 506for electrical coupling to conductive elements 591 on the electronicsassembly 550. The conductive areas 506 can be coupled to conductivetraces 590 placed on the patch surface 505s or within the patch 505. Theconductive elements on the electronics assembly 550 can be coupled toone or both controllers and current source 570.

Detachment elements 600 can be spring loaded and can be configured to beengaged by the fingers of a user. In particular embodiments, detachmentelements 600 may include or be mechanically coupled to one or moreanchoring elements 601 such as a hook for anchoring into patch 505. Theanchoring elements may also comprise adhesive areas placed on thehousing bottom surface 561 which engage the patch surface 505S.

In use, detachment elements 600 allow the user to attach and detach anelectronics assembly 550 to a selected patch 505. This allows theelectronics assembly 550 to be reused for multiple patches. In anexemplary embodiment of using system 500, the user can obtain aparticular patch 505, scan information about the patch using a bar codereader (or other indicia reading means) described below and then attachthe patch 505 to the assembly 550. When the user is done using the patch(e.g., such as when the desired amount of drug has been delivered) theuser then detaches assembly 550 from the patch 505 discarding the patch.In particular embodiments, assembly 550 can include programming whichprovides a signal such as beep or other alarm indicating to the userwhen to remove the patch 505. As an alternative, the patch surface 505scan include an indicator portion which changes color or otherwiseprovides visible indicia to the user when the required amount of agenthas been delivered to the skin. In one embodiment, the indicia cancomprise a symbol or marking that becomes visible when the amount oftherapeutic agent has been delivered. Visibility of the marking can bedue to depletion of therapeutic agent within the patch and/or a chemicalor electrochemical reaction within or one the patch.

In particular embodiments, the electronics assembly 550 can also includea bar code reader for reading a bar code printed on the patch forascertaining various information about the patch 505 including the typeand amount of drug contained in the patch, a desired delivery regimen,lot numbers (of the patch and the therapeutic agent) shelf life,expiration date and related information. The patch may also contain amemory chip such as an EEPROM which contains similar information and isengaged by electronics assembly 550. Assembly 550 may also contain anEEPROM or other memory resource for storing information (describedabove). The EEPROM can couple to the microcontroller and can beprogrammed at the factory or by the doctor or pharmacist. This can bedone directly or over a network such as the internet or cellular phonenetwork or other like network. Other indicia reading means, forreading/detecting other indicia of information about patch 505 are alsocontemplated. Such indicia reading means can include without limitationuse of various RF ID chips known in the art.

System 500 including patch 505 and assembly 550, can be sized and shapedto be placed in any number of locations on the patient's skin includingthe arm, leg or abdomen, back or other location. The particular materialproperties of the patch 505 and housing 560 (e.g., thickness, modulus ofelasticity, bendability, etc) can also be so selected to allow placementat the desired location. For example, more flexible material propertiescan be selected for placement of the system over skin areas with greateramounts of bending by the user, such as the stomach. Also, patch 505 andassembly 550 can be packaged together, for example, as a kit 500 k(which can include instructions for use) wherein the assembly 550 ismatched to patch 505 in terms of size, current source, programmingmechanical properties etc. Further, a given assembly 550 can becalibrated for such a group of patches 505 or patches 505 from aparticular lot number. In such embodiments, multiple patches 505 can beincluded with a particular assembly 550. In use, this allows the patientto obtain a complete supply of patches to meet the delivery requirementsfor a particular therapeutic agent 102 over a period of days, weeks, ormonths. Further, the assembly 550 can be programmed such that when thepatient is near the end of his or supply of patches, that the assemblywill give the patient will a message to purchase more strips. In relatedembodiments, the assembly 550 can be configured to interface with theInternet and/or a mobile communication device such as cell phone, tosend a message to the patient's pharmacy and/or doctor to do one or moreof the following: i) renew the patient's prescription for a particulartherapeutic agent patch 505; ii) have an order for a supple of thetherapeutic agent patch 505 ready for the patient's pick up at his orher drug store; and/or iii) ship an order for the therapeutic agentpatch to the patient's house.

Applications

Numerous applications exist for embodiments described herein. Table 1lists, for example, various medical conditions that may be treated withvarious drugs and other active agents, using a system of electrodeassemblies such as described above. The table further identifies whetherthe treatment can be patient activated, sensor activated, timed, orcontinuous. If patient activated, a user input mechanism 342 (FIG. 3)may be operated by the user when the electrode assemblies are in thedeployed state to initiate operation of the electrode assemblies (anddelivery of the active agent). Examples of user activated applicationsinclude delivery of various pain management drugs such as lidocaine orfentanyl. Sensor activated uses may incorporate use of one or moresensors 344 that interface with the user's body to determine whether acondition of the user requires treatment with the identified activeagent. An example of a sensor activated application can includetreatment of diabetes where the sensor is a blood glucose sensor or(other sensor means for detecting hyperglycemia) and administers a doseof insulin. A treatment is timed if it incorporates the timer 346 todetermine when to start/stop the delivery durations.

TABLE 1 Con- Patient Sensor tin- Active Agent Condition ActivatedActivated Timed uous Insulin Diabetes X X X GLP-1/Integrin Diabetes X XX Fe²⁺ Anemia X Sodium (Na), Electrolyte X Potassium (K) renewalFurosemide Epilepsy X X Bumetanide Migraine X X X Aspirin Inflammation XX X Ketoprophin Arthritis X Lidocaine Pain X Fentanyl Pain X AlprazolinAnxiety/Pain X X Antibiotics Wound X Healing

In specific embodiments, the active agent can comprise a sufficientamount of elemental iron for the treatment of iron deficiency anemia . .. . The amount of elemental iron can be sufficient to provide between 1to 100 mg of elemental iron to the patient for a period of days or evenweeks. In various embodiments, the elemental iron can comprise ioniciron in the form of ferrous (Fe²⁺) or ferric (Fe³⁺) iron. The ionic ironcan comprise an iron salt, a ferrous salt, a ferric salt, ferricpyrophosphate ferrous chloride or a combination thereof.

Although illustrative embodiments of the invention have been describedin detail herein with reference to the accompanying drawings, it is tobe understood that the invention is not limited to those preciseembodiments. As such, many modifications and variations will be apparentto practitioners skilled in this art. Accordingly, it is intended thatthe scope of the invention be defined by the following claims and theirequivalents. Furthermore, it is contemplated that a particular featuredescribed either individually or as part of an embodiment can becombined with other individually described features, or parts of otherembodiments, even if the other features and embodiments make nomentioned of the particular feature. This, the absence of describingcombinations should not preclude the inventor from claiming rights tosuch combinations.

What is claimed is:
 1. A patch assembly for iontophoretic transdermaldelivery of a therapeutic agent to a patient, the assembly comprising: aconformable patch having two electrodes, the patch having a tissuecontacting side including an adhesive and a non-tissue contacting side,each of the electrodes including a porous layer to allow for theiontophoretic transdermal delivery of the therapeutic agent to thepatient through the tissue contacting side, each of the electrodesconfigured to hold a medium to contain the therapeutic agent; a housinghaving a top surface and a bottom surface, the bottom surface configuredto engage the non tissue contacting side of the conformable patch; acurrent source positioned in or on the housing, the current sourceconfigured to deliver direct current; a power inverter coupled to thecurrent source, the power inverter configured to convert direct currentfrom the current source to alternating current; and a controllerpositioned in or on the housing and configured to receive an alternatingcurrent and cause dispersion of the therapeutic agent to alternatebetween electrodes; wherein the housing has sufficient flexibility suchthat when the housing is engaged with the conformable patch to form thepatch assembly, adhering the conformable patch to a target site on thepatient's skin, the patch assembly has sufficient flexibility to deformwith movement of the patient's skin so as to remain sufficiently adheredto the patient's skin over an extended period of time to transdermallydeliver the agent.
 2. The assembly of claim 1, where in the extendedperiod of time is at least at day.
 3. The assembly of claim 2, where inthe extended period of time is at least three days.
 4. The assembly ofclaim 3, where in the extended period of time is at least seven days. 5.The assembly of claim 1, further comprising at least one contact elementpositioned on the bottom surface of the housing for engaging and makingelectrical contact with the non tissue contacting side of the patch. 6.The assembly of claim 5, wherein, the contact element is operativelycoupled to the controller.
 7. The assembly of claim 1, wherein thehousing includes at least one detachment element for mechanicallydisengaging the housing from the conformable patch.
 8. The assembly ofclaim 7, wherein the detachment element is spring loaded.
 9. Theassembly of claim 1, wherein the controller comprises a first controllerfor controlling the delivery of the therapeutic agent and a secondcontroller for controlling the delivery of current to the skin, wherethe first controller is configured to receive the alternating currentand control the iontophoretic delivery of the therapeutic agent.
 10. Theassembly of claim 9, further comprising a current switching deviceoperatively coupled to at least one of the first controller, the secondcontroller or the current source.
 11. The assembly of claim 10, whereinthe current switching device comprises an H-bridge.
 12. The assembly ofclaim 1, wherein the current source comprises an electrochemicalbattery, an alkaline battery, a lithium battery or a lithium-ionbattery.
 13. The assembly of claim 1, wherein the bottom surface of thehousing has a curved contour.
 14. The assembly of claim 13, wherein thecurved contour corresponds to the contour of an arm, a leg or anabdomen.
 15. The assembly of claim 1, wherein the housing has a profileshaped and sized to allow the patch assembly to be worn underneath thepatient's clothing without substantially detaching from the patient'sskin from movement of the patient's clothing or skin.
 16. The assemblyof claim 1, wherein the housing is conformable to a flexing contour ofthe patient's skin to allow the patch assembly to remain adhered topatient's skin over the extended period of time.
 17. The assembly ofclaim 16, wherein the housing is conformable to a flexing contour of thepatient's abdomen.
 18. The assembly of claim 1, wherein the housingcomprises a resilient polymer or an elastomer.
 19. The assembly of claim1, further comprising an input mechanism operatively coupled to thecurrent source, the input mechanism configured to enable the patient toturn the current source on and off.
 20. The assembly of claim 1, furthercomprising a bio-sensor coupled to the controller, the bio-sensorconfigured to detect a medical characteristic of the patient, whereinthe controller controls the iontophoretic delivery of the therapeuticagent based on the medical characteristic.
 21. The assembly of claim 1,wherein the housing has a flexibility to allow the patch assembly todeform with movement of the patient's skin.
 22. The assembly of claim 1,wherein the housing includes one or more zones of increased flexibilitywhich approximately align with at least one of the electrodes of theconformable patch.
 23. The assembly of claim 1, wherein the housing isconfigured to allow the patch assembly to deform with movement of thepatient's skin so as to not substantially affect the delivery of thetherapeutic agent from the at least one electrode which is configured tohold the medium to contain the therapeutic agent as a result of forcesfrom movement of the skin.
 24. The assembly of claim 23, wherein thehousing has a flexibility configured to allow the patch assembly todeform with movement of the patient's skin so as to not substantiallyaffect the rate or total amount of delivery of the therapeutic agentfrom the at least one electrode which is configured to hold the mediumto contain the therapeutic agent as a result of forces from movement ofthe skin.
 25. The assembly of claim 1, wherein the therapeutic agentcomprises elemental iron for treatment of iron deficient anemia.
 26. Theassembly of claim 25, wherein the patch assembly remains sufficientlyadhered to the patient's skin for a sufficient period of time so as totransdermally deliver a therapeutic dose of elemental iron for thetreatment of iron deficient anemia.
 27. The assembly of claim 26,wherein the therapeutic dose of elemental iron is in the range of about1 to about 100 mg.
 28. The assembly of claim 1, wherein causingdispersion of the therapeutic agent to alternate between electrodesenables continuous transdermal delivery of the therapeutic agent usingalternating points of the patient's skin to avoid skin irritation orsaturation.